Network hospitals
3000+
Incurred claim ratio
102.35%
Sum insured
Up to 50 Lakh
No. of Plans
13
Solvency Ratio
0.3
Pan India Presence
1730
Network hospitals
3000+
Incurred claim ratio
102.35%
Sum insured
Up to 50 Lakh
No. of Plans
13
Solvency Ratio
0.3
Pan India Presence
1730
National Insurance Mediclaim Policy is a traditional health insurance plan that provides comprehensive coverage to the policyholders. This plan was launched by the National Insurance Company to offer financial comfort to the insured at the time of a medical emergency. The Policy provides for Pre Hospitalisation (45 days) and Post Hospitalisation (60 days) expenses, 140+ Day Care procedures, organ donor's medical expenses, ambulance charges, Morbid Obesity treatment, correction of Refractive Error and provides for reinstatement of Basic Sum Insured (above SI of 6L), if applicable as per terms.
National Health Insurance
Child Entry Age
3 months
Adult Entry Age
18 to 65 years
Plan Type
Individual/Family Floater
Policy Term
1 Year
Initial Waiting Period
30 Days
Sum Insured
1 L | 2 L | 3 L | 4 L | 5 L | 7 L | 10 L
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
With wide coverage options, National Insurance Mediclaim Policy lets you customize your health insurance plan as per your needs and requirements:
In-patient & Out-patient coverage
Room Rent
Up to 1% of SI
ICU Charges
Up to 2% of SI
Pre-Hospitalization
Covered up to 45 days
Post-Hospitalization
Covered up to 60 days
Domiciliary Hospitalization
Not Covered
Daycare Treatment
140+ procedures
OPD Charges
Not Covered
Coverage Terms
COVID-19 Treatment
Covered
Cataract
Not Covered
No Claim Bonus
Available up to 50% of SI
Automatic Restoration
Not Available
Daily Hospital Cash
Not available
Organ Donor
Covered
Maternity Cover
Not Covered
New Born Baby Cover
Not available
Alternative Treatments
AYUSH Treatment
Covered up to SI
IVF Treatment
Not Available
Modern Treatment
Up to 25% of SI
Emergency Coverage
Ambulance
Covered up to 2k
Air Ambulance
Not Available
Compassionate Travel
Not Available
Global Coverage
Not Available
Wellness Programmes
E-Consultation
Not Available
Health Check-Up
Every 4 claim free years
Second Medical Opinion
Not Available
Vaccination
Not Available
Limitations
Co-payment
Up to 20% Available
Sub-limits
Not Available
The room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.
Common room categories covered under room rent are:
Coverage status under National Mediclaim Policy?
Under National Mediclaim Policy, the room rent is covered by up to 1% of the SI subject to a maximum of Rs. 10,000/- per day.
It is a special department in the hospitals where patients with serious medical conditions are treated.
Coverage status under National Mediclaim Policy?
Under this plan, ICU charges coverage is available up to 2% of the SI.
Under National Mediclaim Policy, the room rent is covered up to INR 20,000 per day
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under National Mediclaim Policy?
This plan covers medical expenses incurred during pre-hospitalization for up to 45 days.
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under National Mediclaim Policy?
This plan covers medical expenses incurred during post-hospitalization for up to 60 days.
Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under National Mediclaim Policy?
Under National Mediclaim Policy, domiciliary hospitalizations are not covered.
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under National Mediclaim Policy?
This plan covers expenses of 140+ daycare procedures
Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.
Coverage status under National Mediclaim Policy?
Not covered under the plan.
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.
Coverage status under National Mediclaim Policy?
Covid-19 Covered.
A common eye condition in which your vision gets blurred.
Coverage status under National Mediclaim Policy?
Under this plan, you are not covered for cataract treatment.
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.
Coverage status under National Mediclaim Policy?
The plan offers a maximum of up to 50% of the sum insured.
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under National Mediclaim Policy?
The plan does not offer automatic restoration.
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under National Mediclaim Policy?
The daily hospital cash is unavailable under this policy but has a limit of room rent per day explained in the given table.
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under National Mediclaim Policy?
Under the plan, Organ Donor expenses are not covered.
It refers to the cover that includes expenses for normal and c-section procedures deliveries.
Coverage status under National Mediclaim Policy?
The maternity cover available under this plan is not covered.
It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover are listed below and these common treatments can vary from plan to plan:
Coverage status under National Mediclaim Policy?
Not covered under this plan
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
Coverage status under National Mediclaim Policy?
AYUSH treatment is covered under this plan up to SI
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Coverage status under National Mediclaim Policy?
Not available
Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under National Mediclaim Policy?
Modern Treatment is covered for up to 25% of SI.
An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.
Coverage status under National Mediclaim Policy?
This plan covers ambulance charges up to INR 2000.
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Coverage status under National Mediclaim Policy?
Not covered
Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.
Coverage status under National Mediclaim Policy?
Not available
Any kind of medical/health emergency when you are outside of India.
Coverage status under National Mediclaim Policy?
Not available
If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
Coverage status under National Mediclaim Policy?
The plan does not cover the expenses for e-consultation.
A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.
Coverage status under National Mediclaim Policy?
The plan offers a Health Check-up benefit for every 4 claim free years.
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company’s network of medical practitioners.
Coverage status under National Mediclaim Policy?
The plan does not cover expenses for Second Medical Opinion.
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under National Mediclaim Policy?
The plan does not offer vaccination coverage.
In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.
Status under National Mediclaim Policy?
If opted, the policyholder may choose either of the two copayment options- 20% Co-payment on each admissible claim, with a 15% discount on premium.
15% Co-payment on each admissible claim, with a 10% discount on premium.
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.
Status under National Mediclaim Policy?
No sub-limits are available
With wide coverage options, National Insurance Mediclaim Policy lets you customize your health insurance plan as per your needs and requirements:
You can file cashless and reimbursement claims with National Insurance Mediclaim Policies. Here are the ways to do so:
These are the fastest modes of making a claim. The policyholder can visit the network hospital of the company, avail of the treatment and after verification, the money will be deposited directly into the hospital's account. Here are the steps to file a cashless claim:
Step 1: Notify the insurer 72 hours before the hospitalization. In case of an emergency, inform the company within 24 hours of hospitalization.
Step 2: On admission, a pre-hospitalization intimation will be sent to the TPA by the hospital. They will provide the estimation of the expenses and the treatment procedures. Gather all the necessary documents that support the claims.
Step 3: Submit all the documents along with the duly filled claim form.
Step 4: The company will verify all the documents.
Step 5: After verification of the documents, the company will transfer the amount directly to the hospital. Following the submission of the documents, this will take about 15 days.
With reimbursement claims, the policyholder gets the privilege to avail of treatment at any non-network hospital. Here are the steps:
Step 1: Inform the company/TPA 72 hours before the admission, and for emergency hospitalization, 24 hours within the hospitalization.
Step 2: After the treatment, gather all the documents, such as medical reports and doctor's consultations, hospital bills. Pre and post-hospitalization expenses can be claimed separately.
Step 3: Submit all the documents and bills, to the insurer, within 15 days of discharge.
Step 4: The company will verify all the details and documents.
Step 5: After verification of the documents, the company will transfer the amount to the policyholder's account.
National Insurance policies come with some amazing features. Read on to find out:
Tax Benefits
Get tax relief under section 80D
Discounts
Avail various discounts
Health Incentives
Get rewarded for your healthy lifestyle & avail regular health check ups
Amount paid towards the premium of this plan is eligible for tax relief under Section 80D of the Income Tax Act, 1961.
Avail 10% discount on online purchase of National Mediclaim Policy
The plan lets the policyholder earn up to 50% of their SI as Health Returns if they follow a healthy lifestyle and stay fit. Expenses of health check up shall be reimbursed.
Expenses related to the surgical treatment of obesity
Cosmetic or plastic surgery
Expenses of hazardous or adventure sports injury treatment
Drug/Alcohol Abuse
IVF
Maternity cover
Dental Treatment
National Health offers a wide range of health insurance plans to fulfill the medical needs of individuals, families, and senior citizens.
Comprehensive
This plan suits you best if you are a newly married individual or have dependents like kids or elderly parents as this health plan covers all of them along with you.
Unique Features
Family Floater
An affordable health plan, that offers 140+ day care procedures and covers pre-existing conditions like diabetes and hypertension.
Unique Features
Family Floater
If you are looking for a healthcare policy providing a high sum assured and covers your family members under one cover this is the right policy for you.
Unique Features
Standard
Standard indemnity health insurance product, having Sum Insured up to 10 Lakhs available in both individuals and floater type.
Unique Features
Super Top-up
This policy covers your family members and offers high coverage at affordable prices.
Unique Features
Comprehensive
A versatile health insurance policy available on an individual and family floater basis offering various optional covers.
Unique Features
Global Coverage
This plan is essential for those who like to travel, a package policy that covers travel emergencies while traveling abroad.
Unique Features
Global Coverage
A plan beneficial for students who are traveling abroad for education, it is designed to cover medical evacuation, illness, and more.
Unique Features
Critical Illness
A unique benefit policy that covers expenses in the event of the insured person being affected with any of the listed critical illnesses.
Unique Features
Senior citizen
Secure your parents' future by providing medical coverage to senior citizens.
Unique Features
Student Specific
Mediclaim for Students is a unique policy designed to provide health and personal accident cover to students.
Unique Features
COVID-19
This policy focuses on protecting the policyholders against the treatment expenses resulting due to COVID-19 infection.
Unique Features
Disability Plan
An indemnity health insurance designed for people falling under the category of disabled, affected with HIV/AIDS, and mental illnesses.
Unique Features
Group Health Plan
It is a group indemnity health insurance plan designed to address the basic health insurance needs of employees.
Unique Features
Accident Policy
This policy is designed to cater to high-risk professionals categorized as the normal, medium, and heavy occupational risk of the person.
Unique Features
As per the IRDAI guidelines, portability is allowed to/from similar products.
Yes, a 10% discount is available.
The plan comes with two co-payment options. These options are:
The National Insurance Company allows the customers to pay their premiums in 2 modes that are:
Cash payment at the branch or Online Payment
For the online payment mode, the policyholder can pay using their Credit Card, Debit Card or Net banking service.
To check the status of your National Insurance Mediclaim policy, you need to visit the official website of the company and login into the portal with your valid credentials.
Yes, a health insurance plan purchased through National Insurance has a 15-day free look period during which the policyholder can return it without any penalties beig charged on him.
National Mediclaim Policy is a good and affordable mediclaim policy which covers you and your family members in case of any medical emergency.
Any individual can be covered who is above 18 years of age under this policy. Children aged between 3 months to 18 years can also be included if at least one of the parents is covered under the same policy.
The maximum entry age for National Mediclaim Policy is 65 years.
Yes. Self, spouse, dependent children and dependent parents can be covered under this policy.
Lifelong policy renewal feature is available for National Mediclaim Policy.
No, this policy does not cover obesity treatments.
No, maternity cover is not available.
Yes, the National Insurance Company allows policyholders to cancel this policy by giving 15 days written notice. However, in case of any such an event, the premium amount is refunded for the unexpired policy period as detailed below:
Period of risk | Rate of premium to be charged |
Up to 1 month | 1/4 of the annual rate |
Up to 3 months | 1/2 of the annual rate |
Up to 6 months | 3/4 of the annual rate |
Exceeding 6 months | Full annual rate |
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